The problems related to a joint like the shoulder They become, on many occasions, a real headache for those who suffer from them. They cause pain and affect mobilitywith all that that entails. “The shoulder is a simple joint composed of the humeral head, which is shaped like a ball, which fits into a flattened cup that is the scapular glenoid. It is the most mobile joint in the human body, but this great mobility means that it is also the joint most prone to dislocationfor its components to separate,” explains the doctor. Vicente de la Vargatraumatologist in Malaga and member of Grupo Top Doctors. One of the problems that can be suffered is the so-called unstable shouldera pathology about which we have spoken with the doctor.
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What is an unstable shoulder?
As the expert details us, an unstable shoulder is called repeated tendency for the shoulder to move out of placeto the head of the humerus dislocating, losing its contact with the glenoid cavity of the scapula with which it articulates. “A single episode of shoulder dislocation does not mean that the shoulder is unstable; this requires multiple dislocations to occur,” the doctor clarifies.
Shoulder dislocation is manifested by very intense pain and inability to move the arm, symptoms that do not disappear until the shoulder is returned to its place.
What are your symptoms?
One of the doubts that arises is how this health problem linked to this joint manifests itself. “Shoulder dislocation is manifested by very intense pain and inability to move the arm, symptoms that do not disappear until the shoulder is returned to its place. In an unstable shoulder the manifestations can range from simple feeling that the shoulder is about to come off until complete dislocation. Patients frequently report that they are able to move the shoulder back into place with minimal effort,” explains Dr. De la Varga.
What are the causes?
The stability of the shoulder depends, above all, on the soft tissues surrounding the joint: joint capsule, ligaments, tendons and muscles. The traumatologist explains to us that When a first episode of shoulder dislocation occurs, these structures are damaged.and if they do not heal properly, a kind of eyelet remains, a break through which the humeral head can emerge again.
© Adobe StockAre there people at greater risk of suffering from it?
Since the most common cause of shoulder instability is dislocation, the doctor clarifies that “this It tends to occur more frequently in young peoplegenerally in their twenties, and related to some type of sporting activity that causes trauma or falls with the arm in a bad position.” And he adds that over 40 years of age it is rare to see patients with shoulder instability. “There is a slight peak of increased frequency in men over 60 years of age due to falls related to age-related loss of strength and stability“, the specialist explains to us.
Once the first episode of shoulder dislocation occurs, it is important to keep the shoulder immobilized in a sling for 3 weeks.
How is it diagnosed?
We ask the doctor what tests are necessary to confirm the diagnosis. “Shoulder instability is suspected due to the history of previous shoulder dislocations and the very characteristic symptoms reported by the patient. he feels like his shoulder is going to come off“, he explains to us
Regarding the necessary diagnostic tests, it indicates that it is confirmed by a magnetic resonance arthrographywhich is an MRI that is performed after paramagnetic contrast has been injected into the joint. “If there is an eyelet, a hole in the joint capsule through which the humeral head can dislocate, the contrast that we inject into the joint will escape through it, and it will be the defect that will have to be repaired,” he says.
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What is the treatment?
Once the diagnosis of unstable shoulder is confirmed, the specialist explains to us that the most important thing is to prevent instability from appearing. “To do this, once the first episode of shoulder dislocation occurs, it is important to keep the shoulder immobilized in a sling for 3 weeks so that the eyelet through which the dislocation occurred heals,” he points out, and clarifies that Even if the treatment is done well, it may not heal well and the shoulder may remain unstable.
“Initially it must strengthen the shoulder muscles to stabilize itbut generally it will require surgical treatment which basically consists of closing the eyelet to prevent the head from escaping. It is a treatment that It is done by arthroscopy through three small incisions and using a microcamera. It requires immobilization of 6 weeks for the repair to heal, but it is usually very effective, the instability disappears and one can return to work or sports activities normally,” he says.
And he concludes by indicating that it is very important to highlight that a shoulder instability must be corrected Well, in addition to limiting our work or sports capacity in the long term, it will lead to tendon injury and shoulder osteoarthritis that is more difficult to solve.
